Cytomegalovirus Infections Clinical Trial
Official title:
Screening for Congenital Cytomegalovirus Infection in Newborns With Failed Hearing Screen or Who Are Small for Gestational Age
Our central hypothesis is that screening newborn infants who either fail their newborn hearing test or have a diagnosis of small for gestational age (SGA) will lead to better identification of infants with congenital CMV infection and enhanced rates of therapeutic intervention. This has the potential to significantly improve outcomes for infants with this common viral infection. This particular cohort of patients have not been well studied locally or regionally. In addition, in view of current legislation that will be effective in January, 2016 this is a timely project that will provide preliminary data for future statewide recommendations around CMV testing of newborn infants. This will be a pilot/feasibility study to obtain preliminary data for an Illinois Department of Public Health (IDPH) Title V grant. Although not guaranteed, preliminary discussions with the IDPH are highly encouraging giving the statewide interest in this topic.
Congenital cytomegalovirus (CMV) infection is the leading non-genetic cause of sensorineural
hearing loss (SNHL) in children in the United States, and is the most frequent known viral
cause of mental disability. Approximately one percent of all newborn infants in the United
States are infected with CMV. Of those infected, approximately 10% have involvement that is
evident at birth (symptomatic congenital CMV disease) with manifestations including
microcephaly, central nervous system abnormalities, chorioretinitis, hepatosplenomegaly, and
SNHL. The most common sequelae following congenital CMV infection is SNHL and it occurs in up
to 50% of infants with symptomatic congenital CMV infection and in 15% of asymptomatic
infants. Overall, congenital CMV infection accounts for one-third of all cases of SNHL. Among
newborn infants who fail hearing screening, the prevalence of congenital CMV infection is
much higher (six to 10%) than the general newborn population (<1%). Since early therapeutic
intervention for infants with symptomatic congenital CMV infections improves audiological and
neurodevelopmental outcomes early diagnosis is essential for early treatment and maximizing
infant outcomes.
The Illinois Legislature passed a bill that was signed into law in August 2015 by Governor
Rauner regarding congenital CMV. The main objectives of this law are public education
regarding CMV infection and efforts to raise awareness of this infection amongst healthcare
providers caring for expectant mothers. This Public Act mandates parents receive information
regarding testing opportunities and early intervention services for CMV infection when their
newborn infant fails his or her hearing screen. Although this bill does not mandate CMV
screening, it does state that the hospitals have to provide information about testing
options.
Our central hypothesis is that screening newborn infants who either fail their newborn
hearing test or have a diagnosis of small for gestational age (SGA) will lead to better
identification of infants with congenital CMV infection and enhanced rates of therapeutic
intervention. This has the potential to significantly improve outcomes for infants with this
common viral infection. This particular cohort of patients have not been well studied locally
or regionally. In addition, in view of current legislation that will be effective in January,
2016 this is a timely project that will provide preliminary data for future statewide
recommendations around CMV testing of newborn infants. This will be a pilot/feasibility study
to obtain preliminary data for an Illinois Department of Public Health (IDPH) Title V grant.
Although not guaranteed, preliminary discussions with the IDPH are highly encouraging giving
the statewide interest in this topic.
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